Risk-Weight Calculation of Candidate Risk Factors for Incidental Osteoporotic Fracture in Patients with Rheumatic Diseases: A Potentially Accurate Approach
<b>Background/Objectives</b>: To assess the risk of osteoporotic fractures in patients with rheumatic diseases (RDs), we introduced a new approach for predicting incident osteoporotic fractures (OF), employing a risk-weight calculation for each candidate risk factor. <b>Methods<...
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2025-01-01
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| author | Ichiro Yoshii Naoya Sawada Tatsumi Chijiwa |
| author_facet | Ichiro Yoshii Naoya Sawada Tatsumi Chijiwa |
| author_sort | Ichiro Yoshii |
| collection | DOAJ |
| description | <b>Background/Objectives</b>: To assess the risk of osteoporotic fractures in patients with rheumatic diseases (RDs), we introduced a new approach for predicting incident osteoporotic fractures (OF), employing a risk-weight calculation for each candidate risk factor. <b>Methods</b>: RD outpatients were picked up, and their histories, including OFs, were studied. A Cox regression analysis that evaluated candidate risk factors was conducted with a multivariate model. The variants were selected as candidate risk factors that showed statistical significance using a univariate model. Using the risk ratio or the β-value and <i>p</i>-value, different approaches to acquire a total risk weight (TRW) for each patient were determined to compare the sensitivity and specificity among the approach methods. The cut-off index (COI) was determined using receiver operating characteristic analysis. Sensitivity and specificity for incident OFs were determined using the Kaplan–Meier survival analysis. <b>Results</b>: In a total of 1228 patients, incidental OF occurred in 179 (14.58%) who were included. Factors with significantly higher risk ratios were a history of vertebral and non-vertebral fractures (<i>p</i> < 0.001), cognitive impairment (<i>p</i> < 0.001), anti-osteoporosis drug intervention (<i>p</i> < 0.001), and rehabilitation (<i>p</i> < 0.001). The excellent approach to acquire the best sensitivity and specificity was to calculate the β-value multiplied by the logarithm of the <i>p</i>-value based on 0.05, including non-significant factors (sensitivity: 31.2%, specificity: 94.9%, and area under the curve (AUC): 0.774) compared to 29.4%, 91.6%, and 0.723, respectively, with a counted significant risk factors approach. <b>Conclusions</b>: This novel approach, which includes non-significant factors, can achieve a more accurate sensitivity and specificity to accidental OF in patients with RDs. |
| format | Article |
| id | doaj-art-5842df28fd1f4d15bbcd8cc287a71618 |
| institution | DOAJ |
| issn | 2673-4036 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | MDPI AG |
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| series | Osteology |
| spelling | doaj-art-5842df28fd1f4d15bbcd8cc287a716182025-08-20T02:42:28ZengMDPI AGOsteology2673-40362025-01-0151510.3390/osteology5010005Risk-Weight Calculation of Candidate Risk Factors for Incidental Osteoporotic Fracture in Patients with Rheumatic Diseases: A Potentially Accurate ApproachIchiro Yoshii0Naoya Sawada1Tatsumi Chijiwa2Department of Musculoskeletal Medicine, 6-7-5 Nakamura-Ohashidori, Shimanto-City 787-0033, JapanDepartment of Rheumatology, Dohgo-Onsen Hospital Rheumatology Center, 21-21 HImetsuka-Otsu, Matsuyama 790-0858, JapanDepartment of Rheumatology, Kochi Memorial Hospital, 4-13 Shiromi-cho, Kochi 780-0824, Japan<b>Background/Objectives</b>: To assess the risk of osteoporotic fractures in patients with rheumatic diseases (RDs), we introduced a new approach for predicting incident osteoporotic fractures (OF), employing a risk-weight calculation for each candidate risk factor. <b>Methods</b>: RD outpatients were picked up, and their histories, including OFs, were studied. A Cox regression analysis that evaluated candidate risk factors was conducted with a multivariate model. The variants were selected as candidate risk factors that showed statistical significance using a univariate model. Using the risk ratio or the β-value and <i>p</i>-value, different approaches to acquire a total risk weight (TRW) for each patient were determined to compare the sensitivity and specificity among the approach methods. The cut-off index (COI) was determined using receiver operating characteristic analysis. Sensitivity and specificity for incident OFs were determined using the Kaplan–Meier survival analysis. <b>Results</b>: In a total of 1228 patients, incidental OF occurred in 179 (14.58%) who were included. Factors with significantly higher risk ratios were a history of vertebral and non-vertebral fractures (<i>p</i> < 0.001), cognitive impairment (<i>p</i> < 0.001), anti-osteoporosis drug intervention (<i>p</i> < 0.001), and rehabilitation (<i>p</i> < 0.001). The excellent approach to acquire the best sensitivity and specificity was to calculate the β-value multiplied by the logarithm of the <i>p</i>-value based on 0.05, including non-significant factors (sensitivity: 31.2%, specificity: 94.9%, and area under the curve (AUC): 0.774) compared to 29.4%, 91.6%, and 0.723, respectively, with a counted significant risk factors approach. <b>Conclusions</b>: This novel approach, which includes non-significant factors, can achieve a more accurate sensitivity and specificity to accidental OF in patients with RDs.https://www.mdpi.com/2673-4036/5/1/5beta valueosteoporotic fracturerheumatic diseasesrisk ratiorisk weight |
| spellingShingle | Ichiro Yoshii Naoya Sawada Tatsumi Chijiwa Risk-Weight Calculation of Candidate Risk Factors for Incidental Osteoporotic Fracture in Patients with Rheumatic Diseases: A Potentially Accurate Approach Osteology beta value osteoporotic fracture rheumatic diseases risk ratio risk weight |
| title | Risk-Weight Calculation of Candidate Risk Factors for Incidental Osteoporotic Fracture in Patients with Rheumatic Diseases: A Potentially Accurate Approach |
| title_full | Risk-Weight Calculation of Candidate Risk Factors for Incidental Osteoporotic Fracture in Patients with Rheumatic Diseases: A Potentially Accurate Approach |
| title_fullStr | Risk-Weight Calculation of Candidate Risk Factors for Incidental Osteoporotic Fracture in Patients with Rheumatic Diseases: A Potentially Accurate Approach |
| title_full_unstemmed | Risk-Weight Calculation of Candidate Risk Factors for Incidental Osteoporotic Fracture in Patients with Rheumatic Diseases: A Potentially Accurate Approach |
| title_short | Risk-Weight Calculation of Candidate Risk Factors for Incidental Osteoporotic Fracture in Patients with Rheumatic Diseases: A Potentially Accurate Approach |
| title_sort | risk weight calculation of candidate risk factors for incidental osteoporotic fracture in patients with rheumatic diseases a potentially accurate approach |
| topic | beta value osteoporotic fracture rheumatic diseases risk ratio risk weight |
| url | https://www.mdpi.com/2673-4036/5/1/5 |
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